622 Baseline inflammatory indexes and clinicopathological features to predict the outcome of acute interstitial nephritis

Abstract Backgrounds-and-aims Acute tubulointerstitial nephritis(AIN) is a rare cause of acute kidney injury(AKI). We aimed to investigate the characteristics of AIN patients and predictive factors for treatment response. Method 31 patients diagnosed with AIN by biopsy between 2006-2021 were include...

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Veröffentlicht in:Nephrology, dialysis, transplantation dialysis, transplantation, 2024-05, Vol.39 (Supplement_1)
Hauptverfasser: Dirim, Ahmet Burak, Namazova, Nazrin, Dirim, Merve Guzel, Oto, Ozgur Akin, Artan, Ayse Serra, Hurdogan, Ozge, Ozluk, Yasemin, Yazici, Halil
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container_title Nephrology, dialysis, transplantation
container_volume 39
creator Dirim, Ahmet Burak
Namazova, Nazrin
Dirim, Merve Guzel
Oto, Ozgur Akin
Artan, Ayse Serra
Hurdogan, Ozge
Ozluk, Yasemin
Yazici, Halil
description Abstract Backgrounds-and-aims Acute tubulointerstitial nephritis(AIN) is a rare cause of acute kidney injury(AKI). We aimed to investigate the characteristics of AIN patients and predictive factors for treatment response. Method 31 patients diagnosed with AIN by biopsy between 2006-2021 were included in this retrospective study. Baseline clinical, pathological, and laboratory findings, including CBC(complete blood count), creatinine, serum-immune-inflammation-index(SII), neutrophil-to-lymphocyte ratio(NLR), and platelet-to-lymphocyte ratio(PLR) were evaluated. Also, treatment response and creatinine levels at the last follow-up were noted. Results Median age was 46 years, and 80.6% of the patients were female. Median baseline creatinine and proteinuria levels were 4.1 mg/dL and 0.84 g/g or g/day. Median follow-up was 14 months. 93.5% of patients received immunosuppressives. End-stage-kidney-disease(ESKD) developed in five patients. Renal recovery(creatinine < 1.4 mg/dL) was observed in 17 (54.8%) patients. Global glomerulosclerosis percentage, interstitial fibrosis(IF), tubular atrophy(TA), granuloma formation, and higher baseline hemoglobin levels were associated with poor renal outcomes(non-responder). Also, ESKD-developed patients had higher baseline hemoglobin(p = 0.033) and lymphocyte(p = 0.044) and lower PLR levels(p = 0.016), as well as higher degrees of global glomerulosclerosis(p = 0.014), IF(p = 0.042), and TA(p = 0.030). Conclusion Treatment rates are low for AIN, which may lead to ESKD. Besides chronicity in pathology specimens, higher baseline hemoglobin levels and lower PLR might be prognostic for AIN. Further studies should be conducted on new markers for AIN. Table: Baseline clinical/laboratory/pathology and treatment data of responder(last serum creatinine < 1.4 mg/dL) and non-responder groups. No Response Responder Parameters (n = 14) (n = 17) p-value Age, median (min-max) 44 (21-61) 44.5 (17-71) 0.874 Sex, F/M 10/4 15/2 0.370 Creatinine (mg/dl) 3.8 (2.4-9.1) 4.32 (1.03-11.2) 0.677 eGFR (CKD-EPI) 16.9 (4.7-32) 11.29 (3.69-70) 0.525 Albumin, mean ± std 3.9 ± 0.8 4.0 ± 0.4 0.573 Hgb 11.8 (6.9-13.8) 9.75 (7.2-11.7) 0.029 Lymph 1400 (400-3300) 1180 (500-1700) 0.140 Neutroph 6500 (3100-24700) 5650 (3270-9900) 0.665 Plt 280000 (75000-645000) 291500 (148600-507000) 0.733 Eos 200 (0-700) 135 (0-300) 0.151 SII 1400 (513.6-5689.8) 1635 (495.7-4563) 0.603 NLR 4.88 (2.3-17.6) 4.97 (2.6-12.6) 0.603 PLR 194.3 (124.2-1123.5) 302.26 (151.6-460.9) 0.225 P
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We aimed to investigate the characteristics of AIN patients and predictive factors for treatment response. Method 31 patients diagnosed with AIN by biopsy between 2006-2021 were included in this retrospective study. Baseline clinical, pathological, and laboratory findings, including CBC(complete blood count), creatinine, serum-immune-inflammation-index(SII), neutrophil-to-lymphocyte ratio(NLR), and platelet-to-lymphocyte ratio(PLR) were evaluated. Also, treatment response and creatinine levels at the last follow-up were noted. Results Median age was 46 years, and 80.6% of the patients were female. Median baseline creatinine and proteinuria levels were 4.1 mg/dL and 0.84 g/g or g/day. Median follow-up was 14 months. 93.5% of patients received immunosuppressives. End-stage-kidney-disease(ESKD) developed in five patients. Renal recovery(creatinine &lt; 1.4 mg/dL) was observed in 17 (54.8%) patients. Global glomerulosclerosis percentage, interstitial fibrosis(IF), tubular atrophy(TA), granuloma formation, and higher baseline hemoglobin levels were associated with poor renal outcomes(non-responder). Also, ESKD-developed patients had higher baseline hemoglobin(p = 0.033) and lymphocyte(p = 0.044) and lower PLR levels(p = 0.016), as well as higher degrees of global glomerulosclerosis(p = 0.014), IF(p = 0.042), and TA(p = 0.030). Conclusion Treatment rates are low for AIN, which may lead to ESKD. Besides chronicity in pathology specimens, higher baseline hemoglobin levels and lower PLR might be prognostic for AIN. Further studies should be conducted on new markers for AIN. Table: Baseline clinical/laboratory/pathology and treatment data of responder(last serum creatinine &lt; 1.4 mg/dL) and non-responder groups. No Response Responder Parameters (n = 14) (n = 17) p-value Age, median (min-max) 44 (21-61) 44.5 (17-71) 0.874 Sex, F/M 10/4 15/2 0.370 Creatinine (mg/dl) 3.8 (2.4-9.1) 4.32 (1.03-11.2) 0.677 eGFR (CKD-EPI) 16.9 (4.7-32) 11.29 (3.69-70) 0.525 Albumin, mean ± std 3.9 ± 0.8 4.0 ± 0.4 0.573 Hgb 11.8 (6.9-13.8) 9.75 (7.2-11.7) 0.029 Lymph 1400 (400-3300) 1180 (500-1700) 0.140 Neutroph 6500 (3100-24700) 5650 (3270-9900) 0.665 Plt 280000 (75000-645000) 291500 (148600-507000) 0.733 Eos 200 (0-700) 135 (0-300) 0.151 SII 1400 (513.6-5689.8) 1635 (495.7-4563) 0.603 NLR 4.88 (2.3-17.6) 4.97 (2.6-12.6) 0.603 PLR 194.3 (124.2-1123.5) 302.26 (151.6-460.9) 0.225 Proteinuria 0.84 (0-8) 0.84 (0-3) 0.766 Follow-up (months) 14 (1-52) 10.5 (2-168) 0.402 Treatments, (%) Steroids, including pulse (92.9) (94.1) 1.000 AZA/MMF (21.4) (0) 0.304 Pulse-steroids (28.6) (17.6) 0.671 Hemodialysis-at-admission (28.6) (17.6) 0.671 AIN Etiology, (%) Unknown, (50) Unknown, (23.5) 0.153 NSAID, (14.3) NSAID, (29.4) 0.412 Antibiotic, (7.1) Antibiotic, (35.2) 0.094 Sarcoidosis, (21.4) Sarcoidosis, (5.9) 0.304 Sjögren, (7.1) Sjögren, (5.9) 1.000 Tubulitis, (%) Not significant (NS) (21.4) (11.8) 0.467 Mild (57.1) (88.2) Moderate (7.1) (0) Severe 2 (14.3) 0 (0) Lymphocytic infiltration, (%) NS (7.1) (0) 0.452 Mild (64.3) (82.4) Mod (21.4) (11.8) Sev (7.1) (5.9) Eosinophilic inf, (%) NS (57.1) (52.9) 0.815 Mild (21.4) (88.2) Mod (7.1) (5.9) Sev (14.3) (11.8) Plasmacytic inf, (%) NS (57.1) (82.4) 0.124 Mild (7.1) (0) Mod (7.1) (0) Sev (28.6) (17.6) Granuloma formation, (%) No (50) (100) 0.012 Mild/microgranuloma (28.6) (0) Moderate (14.3) (0) Extensive (7.1) (0) TA, (%) NS (28.6) (76.5) 0.024 Mild (64.3) (23.5) Mod (7.1) (0) Sev (0) (0) IF, (%) NS (57.1) (94.1) 0.047 Mild (35.7) (5.9) Mod (7.1) (0) Sev (0) (0) Global sclerotic glomeruli (%), median (0-83.3) (0-50) 0.013 Segmental sclerotic glomeruli (%), median 0 (0-9) 0 (0-0) 0.270</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfae069.420</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>Nephrology, dialysis, transplantation, 2024-05, Vol.39 (Supplement_1)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the ERA. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids></links><search><creatorcontrib>Dirim, Ahmet Burak</creatorcontrib><creatorcontrib>Namazova, Nazrin</creatorcontrib><creatorcontrib>Dirim, Merve Guzel</creatorcontrib><creatorcontrib>Oto, Ozgur Akin</creatorcontrib><creatorcontrib>Artan, Ayse Serra</creatorcontrib><creatorcontrib>Hurdogan, Ozge</creatorcontrib><creatorcontrib>Ozluk, Yasemin</creatorcontrib><creatorcontrib>Yazici, Halil</creatorcontrib><title>622 Baseline inflammatory indexes and clinicopathological features to predict the outcome of acute interstitial nephritis</title><title>Nephrology, dialysis, transplantation</title><description>Abstract Backgrounds-and-aims Acute tubulointerstitial nephritis(AIN) is a rare cause of acute kidney injury(AKI). We aimed to investigate the characteristics of AIN patients and predictive factors for treatment response. Method 31 patients diagnosed with AIN by biopsy between 2006-2021 were included in this retrospective study. Baseline clinical, pathological, and laboratory findings, including CBC(complete blood count), creatinine, serum-immune-inflammation-index(SII), neutrophil-to-lymphocyte ratio(NLR), and platelet-to-lymphocyte ratio(PLR) were evaluated. Also, treatment response and creatinine levels at the last follow-up were noted. Results Median age was 46 years, and 80.6% of the patients were female. Median baseline creatinine and proteinuria levels were 4.1 mg/dL and 0.84 g/g or g/day. Median follow-up was 14 months. 93.5% of patients received immunosuppressives. End-stage-kidney-disease(ESKD) developed in five patients. Renal recovery(creatinine &lt; 1.4 mg/dL) was observed in 17 (54.8%) patients. Global glomerulosclerosis percentage, interstitial fibrosis(IF), tubular atrophy(TA), granuloma formation, and higher baseline hemoglobin levels were associated with poor renal outcomes(non-responder). Also, ESKD-developed patients had higher baseline hemoglobin(p = 0.033) and lymphocyte(p = 0.044) and lower PLR levels(p = 0.016), as well as higher degrees of global glomerulosclerosis(p = 0.014), IF(p = 0.042), and TA(p = 0.030). Conclusion Treatment rates are low for AIN, which may lead to ESKD. Besides chronicity in pathology specimens, higher baseline hemoglobin levels and lower PLR might be prognostic for AIN. Further studies should be conducted on new markers for AIN. Table: Baseline clinical/laboratory/pathology and treatment data of responder(last serum creatinine &lt; 1.4 mg/dL) and non-responder groups. No Response Responder Parameters (n = 14) (n = 17) p-value Age, median (min-max) 44 (21-61) 44.5 (17-71) 0.874 Sex, F/M 10/4 15/2 0.370 Creatinine (mg/dl) 3.8 (2.4-9.1) 4.32 (1.03-11.2) 0.677 eGFR (CKD-EPI) 16.9 (4.7-32) 11.29 (3.69-70) 0.525 Albumin, mean ± std 3.9 ± 0.8 4.0 ± 0.4 0.573 Hgb 11.8 (6.9-13.8) 9.75 (7.2-11.7) 0.029 Lymph 1400 (400-3300) 1180 (500-1700) 0.140 Neutroph 6500 (3100-24700) 5650 (3270-9900) 0.665 Plt 280000 (75000-645000) 291500 (148600-507000) 0.733 Eos 200 (0-700) 135 (0-300) 0.151 SII 1400 (513.6-5689.8) 1635 (495.7-4563) 0.603 NLR 4.88 (2.3-17.6) 4.97 (2.6-12.6) 0.603 PLR 194.3 (124.2-1123.5) 302.26 (151.6-460.9) 0.225 Proteinuria 0.84 (0-8) 0.84 (0-3) 0.766 Follow-up (months) 14 (1-52) 10.5 (2-168) 0.402 Treatments, (%) Steroids, including pulse (92.9) (94.1) 1.000 AZA/MMF (21.4) (0) 0.304 Pulse-steroids (28.6) (17.6) 0.671 Hemodialysis-at-admission (28.6) (17.6) 0.671 AIN Etiology, (%) Unknown, (50) Unknown, (23.5) 0.153 NSAID, (14.3) NSAID, (29.4) 0.412 Antibiotic, (7.1) Antibiotic, (35.2) 0.094 Sarcoidosis, (21.4) Sarcoidosis, (5.9) 0.304 Sjögren, (7.1) Sjögren, (5.9) 1.000 Tubulitis, (%) Not significant (NS) (21.4) (11.8) 0.467 Mild (57.1) (88.2) Moderate (7.1) (0) Severe 2 (14.3) 0 (0) Lymphocytic infiltration, (%) NS (7.1) (0) 0.452 Mild (64.3) (82.4) Mod (21.4) (11.8) Sev (7.1) (5.9) Eosinophilic inf, (%) NS (57.1) (52.9) 0.815 Mild (21.4) (88.2) Mod (7.1) (5.9) Sev (14.3) (11.8) Plasmacytic inf, (%) NS (57.1) (82.4) 0.124 Mild (7.1) (0) Mod (7.1) (0) Sev (28.6) (17.6) Granuloma formation, (%) No (50) (100) 0.012 Mild/microgranuloma (28.6) (0) Moderate (14.3) (0) Extensive (7.1) (0) TA, (%) NS (28.6) (76.5) 0.024 Mild (64.3) (23.5) Mod (7.1) (0) Sev (0) (0) IF, (%) NS (57.1) (94.1) 0.047 Mild (35.7) (5.9) Mod (7.1) (0) Sev (0) (0) Global sclerotic glomeruli (%), median (0-83.3) (0-50) 0.013 Segmental sclerotic glomeruli (%), median 0 (0-9) 0 (0-0) 0.270</description><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkEtPwzAQhC0EEqVw5uozUlo_EoccoeIlVeIC52hjr1ujJI5sR6L_HlftndPOamdGq4-Qe85WnDVyPZq03llApppVKdgFWfBSsULIx-qSLLKDF6xizTW5ifGHMdaIul6QgxKCPkPE3o1I3Wh7GAZIPhzyYvAXI4XRUJ3PTvsJ0t73fuc09NQipDlkQ_J0CmicTjTtkfo5aT_kaSnoOR1bE4aYXHI5NeK0D1nGW3JloY94d55L8v368rV5L7afbx-bp22hOT_-zwVwK0XdGctRSWuNaDqhjVQlGACFFUdhsuwUMNRc1o3mIBVqYapOyyVZn3p18DEGtO0U3ADh0HLWHsm1mVx7JtdmcjnxcEr4efrX_AdR9XVz</recordid><startdate>20240523</startdate><enddate>20240523</enddate><creator>Dirim, Ahmet Burak</creator><creator>Namazova, Nazrin</creator><creator>Dirim, Merve Guzel</creator><creator>Oto, Ozgur Akin</creator><creator>Artan, Ayse Serra</creator><creator>Hurdogan, Ozge</creator><creator>Ozluk, Yasemin</creator><creator>Yazici, Halil</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20240523</creationdate><title>622 Baseline inflammatory indexes and clinicopathological features to predict the outcome of acute interstitial nephritis</title><author>Dirim, Ahmet Burak ; Namazova, Nazrin ; Dirim, Merve Guzel ; Oto, Ozgur Akin ; Artan, Ayse Serra ; Hurdogan, Ozge ; Ozluk, Yasemin ; Yazici, Halil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1160-212a1f327bdf1e63ffd29b2cd364adaa6e51e2dadab6a0ec1379c1a36ec2d5bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dirim, Ahmet Burak</creatorcontrib><creatorcontrib>Namazova, Nazrin</creatorcontrib><creatorcontrib>Dirim, Merve Guzel</creatorcontrib><creatorcontrib>Oto, Ozgur Akin</creatorcontrib><creatorcontrib>Artan, Ayse Serra</creatorcontrib><creatorcontrib>Hurdogan, Ozge</creatorcontrib><creatorcontrib>Ozluk, Yasemin</creatorcontrib><creatorcontrib>Yazici, Halil</creatorcontrib><collection>CrossRef</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dirim, Ahmet Burak</au><au>Namazova, Nazrin</au><au>Dirim, Merve Guzel</au><au>Oto, Ozgur Akin</au><au>Artan, Ayse Serra</au><au>Hurdogan, Ozge</au><au>Ozluk, Yasemin</au><au>Yazici, Halil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>622 Baseline inflammatory indexes and clinicopathological features to predict the outcome of acute interstitial nephritis</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><date>2024-05-23</date><risdate>2024</risdate><volume>39</volume><issue>Supplement_1</issue><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>Abstract Backgrounds-and-aims Acute tubulointerstitial nephritis(AIN) is a rare cause of acute kidney injury(AKI). We aimed to investigate the characteristics of AIN patients and predictive factors for treatment response. Method 31 patients diagnosed with AIN by biopsy between 2006-2021 were included in this retrospective study. Baseline clinical, pathological, and laboratory findings, including CBC(complete blood count), creatinine, serum-immune-inflammation-index(SII), neutrophil-to-lymphocyte ratio(NLR), and platelet-to-lymphocyte ratio(PLR) were evaluated. Also, treatment response and creatinine levels at the last follow-up were noted. Results Median age was 46 years, and 80.6% of the patients were female. Median baseline creatinine and proteinuria levels were 4.1 mg/dL and 0.84 g/g or g/day. Median follow-up was 14 months. 93.5% of patients received immunosuppressives. End-stage-kidney-disease(ESKD) developed in five patients. Renal recovery(creatinine &lt; 1.4 mg/dL) was observed in 17 (54.8%) patients. Global glomerulosclerosis percentage, interstitial fibrosis(IF), tubular atrophy(TA), granuloma formation, and higher baseline hemoglobin levels were associated with poor renal outcomes(non-responder). Also, ESKD-developed patients had higher baseline hemoglobin(p = 0.033) and lymphocyte(p = 0.044) and lower PLR levels(p = 0.016), as well as higher degrees of global glomerulosclerosis(p = 0.014), IF(p = 0.042), and TA(p = 0.030). Conclusion Treatment rates are low for AIN, which may lead to ESKD. Besides chronicity in pathology specimens, higher baseline hemoglobin levels and lower PLR might be prognostic for AIN. Further studies should be conducted on new markers for AIN. Table: Baseline clinical/laboratory/pathology and treatment data of responder(last serum creatinine &lt; 1.4 mg/dL) and non-responder groups. No Response Responder Parameters (n = 14) (n = 17) p-value Age, median (min-max) 44 (21-61) 44.5 (17-71) 0.874 Sex, F/M 10/4 15/2 0.370 Creatinine (mg/dl) 3.8 (2.4-9.1) 4.32 (1.03-11.2) 0.677 eGFR (CKD-EPI) 16.9 (4.7-32) 11.29 (3.69-70) 0.525 Albumin, mean ± std 3.9 ± 0.8 4.0 ± 0.4 0.573 Hgb 11.8 (6.9-13.8) 9.75 (7.2-11.7) 0.029 Lymph 1400 (400-3300) 1180 (500-1700) 0.140 Neutroph 6500 (3100-24700) 5650 (3270-9900) 0.665 Plt 280000 (75000-645000) 291500 (148600-507000) 0.733 Eos 200 (0-700) 135 (0-300) 0.151 SII 1400 (513.6-5689.8) 1635 (495.7-4563) 0.603 NLR 4.88 (2.3-17.6) 4.97 (2.6-12.6) 0.603 PLR 194.3 (124.2-1123.5) 302.26 (151.6-460.9) 0.225 Proteinuria 0.84 (0-8) 0.84 (0-3) 0.766 Follow-up (months) 14 (1-52) 10.5 (2-168) 0.402 Treatments, (%) Steroids, including pulse (92.9) (94.1) 1.000 AZA/MMF (21.4) (0) 0.304 Pulse-steroids (28.6) (17.6) 0.671 Hemodialysis-at-admission (28.6) (17.6) 0.671 AIN Etiology, (%) Unknown, (50) Unknown, (23.5) 0.153 NSAID, (14.3) NSAID, (29.4) 0.412 Antibiotic, (7.1) Antibiotic, (35.2) 0.094 Sarcoidosis, (21.4) Sarcoidosis, (5.9) 0.304 Sjögren, (7.1) Sjögren, (5.9) 1.000 Tubulitis, (%) Not significant (NS) (21.4) (11.8) 0.467 Mild (57.1) (88.2) Moderate (7.1) (0) Severe 2 (14.3) 0 (0) Lymphocytic infiltration, (%) NS (7.1) (0) 0.452 Mild (64.3) (82.4) Mod (21.4) (11.8) Sev (7.1) (5.9) Eosinophilic inf, (%) NS (57.1) (52.9) 0.815 Mild (21.4) (88.2) Mod (7.1) (5.9) Sev (14.3) (11.8) Plasmacytic inf, (%) NS (57.1) (82.4) 0.124 Mild (7.1) (0) Mod (7.1) (0) Sev (28.6) (17.6) Granuloma formation, (%) No (50) (100) 0.012 Mild/microgranuloma (28.6) (0) Moderate (14.3) (0) Extensive (7.1) (0) TA, (%) NS (28.6) (76.5) 0.024 Mild (64.3) (23.5) Mod (7.1) (0) Sev (0) (0) IF, (%) NS (57.1) (94.1) 0.047 Mild (35.7) (5.9) Mod (7.1) (0) Sev (0) (0) Global sclerotic glomeruli (%), median (0-83.3) (0-50) 0.013 Segmental sclerotic glomeruli (%), median 0 (0-9) 0 (0-0) 0.270</abstract><pub>Oxford University Press</pub><doi>10.1093/ndt/gfae069.420</doi><oa>free_for_read</oa></addata></record>
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source OUP_牛津大学出版社现刊
title 622 Baseline inflammatory indexes and clinicopathological features to predict the outcome of acute interstitial nephritis
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